Tip 39: Substance Abuse Treatment and Family Therapy National Center on Substance Abuse and Child Welfare

family therapy for substance abuse

Some challenges are related to attitudes and myths about offering family counseling in SUD treatment settings. Still others are related to family issues such as low motivation to change and power dynamics within the family. A useful framework for understanding this process involves the stages of change (SOC) model, a transtheoretical approach to behavior change, originally developed by Prochaska and DiClemente (1984). The SOC model was developed for use with individuals, but it can be a helpful approach to assessing family members’ readiness to discuss a problem that they often view as something so shameful they can’t talk about it.

How Can Family Systems Theory Help Addiction Recovery?

family therapy for substance abuse

It’s a great way to see the bigger picture when dealing with something as sensitive as addiction in a family. In some cases, circumstances and dynamics do warrant treating the SUD before involving the family—as when a family member with an SUD also has a co-occurring disorder not yet stabilized in treatment. In this scenario, it may be best to limit or postpone family-based interventions until stabilization.

  1. One or more family members, particularly those with SUDs, can be mandated to treatment by the criminal justice system, Child Protective Services, or an employer.
  2. Some of the primary goals of family therapy are to create a better home environment, solve family issues, and understand the unique issues that a family might face.
  3. However, research on peer-based RSS for SUD is quite limited in both quantity and quality (Bassuk et al., 2016; Eddie et al., 2019), with virtually no studies testing impacts on CSO wellness specifically (but see Carpenter et al., 2020).
  4. Substance abusetriggers and consequences are sought, as well as interpersonal cues and positiveconsequences that support more adaptive, sober behaviors.

Promoting Personal and Family Wellness

These interventions can be brief, emphasizing psychoeducation, parenting skills training, and supportive services. They can also be intensive, with case management and outpatient or inpatient programming that explores family dynamics and relational issues. If your clients need intensive case management, your role as an SUD treatment provider is to link them and their families to specialized services. These services can range from less intensive (e.g., general case management support services) to more intensive (e.g., wraparound services, assertive community treatment programs) (Rapp et al., 2014). If clients and their families need less intensive case management services, act as a community liaison by initiating contact with other agencies that can provide services to them. You can inform clients about resources in the community, collaborate with other service providers, and advocate for clients and their families when needed.

Symptoms of alcohol use disorder

While it frequently involves all family unit members, it may also focus on those who are willing or able to participate in treatment. Further research is needed to better understand how family therapy may be most effective and how it compares to other forms of treatment. Because this form of treatment addresses communication, family members can learn how to better share their thoughts and needs and resolve conflicts in a way that is less likely to damage relationships. Like treatment for other chronic diseases such as heart disease or asthma, addiction treatment is not a cure, but a way of managing the condition. Treatment enables people to counteract addiction’s disruptive effects on their brain and behavior and regain control of their lives. Prepare for family therapy by making a list of questions to ask the family therapist so you understand their style and what you can expect in sessions.

What Are The Four Subsystems in Family Systems Theory?

When he is drinking, he puts the car in the garage so that neighbors will not notice that he is drunk. When Bev sees the car in the garage, she remembers the many times that Harry came home drunk. Bev goes into the ultimate guide to alcohol recovery books a panic and starts screaming at him when she sees the car in the garage, even though Harry has not been drinking. Plan for follow-up meetings to address ongoing recovery and relapse prevention concerns.

Assessment Resources

Keeping family relationships healthy takes work, especially when dealing with addiction. Recognizing one’s role in the cycle of addiction helps people understand what they can do to improve their situation. Together, you can overcome alcohol use behaviors and embrace a new family dynamic where individuals feel valued and heard, and unhelpful behavior patterns are a thing of the past. This final stage is considered relatively stable in comparison to the earlier three stages. This is because recovery is now solid, and attention can be turned back to the person with alcohol use disorder and the family. This may happen through the realization that the family can’t control and enable the drinking, and that only when the person living with alcohol use disorder reaches out for help outside the family system can they move into the stage of transition.

How do behavioral therapies treat drug addiction?

The model views families as systems, and in any system, each part is related to all other parts. A change in any part of the system will bring about changes in all other parts (Becvar & Becvar, 2018). Family counseling uses family dynamics and strengths to bring about change in a range of diverse problem areas, including SUDs. Peer recovery support services for people with SUDs have demonstrated efficacy in helping people initiate and sustain recovery (Bassuk, Hanson, Greene, Richard, & Laudet, 2016). A family-focused peer recovery support specialist is a nonclinical provider who is trained and supervised in providing education, support, and resources to family members who have a family member with an SUD.

The U.S. Food and Drug Administration (FDA) has approved three medications for treating alcohol dependence, and others are being tested to determine whether they are effective. Research shows that about one-third of people who are treated for alcohol problems have no further symptoms 1 year later. Many others substantially reduce their drinking and report fewer alcohol-related problems.

family therapy for substance abuse

The number of sessions and frequency depend on the family’s needs and goals for treatment. Based on clinical experience, many health providers believe that support from friends and family members is important in overcoming alcohol problems. But friends and family may feel unsure about how best to provide the support needed. Evaluate the coverage in your health insurance plan to determine how much of the costs your insurance will cover and how much you will have to pay. Ask different programs if they offer sliding scale fees—some programs may offer lower prices or payment plans for individuals without health insurance. Ultimately, choosing to get treatment may be more important than the approach used, as long as the approach avoids heavy confrontation and incorporates empathy, motivational support, and a focus on changing drinking behavior.

Research shows lower levels of adolescent substance use and risk for SUD diagnosis when parents complete the FCU intervention (Hernandez et al., 2015). A systematic review and meta-analysis found that FCU as part of a larger school-based approach reduced marijuana use among adolescents (Stormshak et al., 2011; Vermeulen-Smit, Verdurmen, & Engels, 2015). Recent adaptation of MST for emerging adults who are aging out of the child welfare system follows the principles of MST but shifts the primary agent of change from parents to the emerging adult and the emerging adult’s social network, which may or may not include the parents.

This approach focusesconsiderable effort on overcoming initial resistance to treatment because theprocess embodies the family’s issues around the adolescent’s substance use(Santisteban and Szapocznik, 1994;Szapocznik and Kurtines, 1989). Therapists should plan for followup and support as part of the terminationprocess. Residential programs, for example, can hold support groups run byalumni or counselors that are available weekly for family members who want toattend is it dangerous to drink alcohol while taking steroids on a voluntary, as-needed basis. Some practitioners ask the client andfamily members to call them after 6 months or 1 year for a followupconversation. Depending on the family’s needs, the therapist may be able toprovide reinforcement without further meetings, or may suggest one or twofollowup sessions to address emerging issues. The majority of family therapy is conducted on a short-term basis, with someexceptions (Object Relations therapy may take years).

On March 1, 2022, President Biden announced his administration’s strategy to address our nation’s mental health crisis as outlined in the 2022 Presidential Unity Agenda. To meet this goal, SAMHSA collaborated with federal, state, tribal, territorial, and local partners including peer specialists to develop the National Model Standards for Peer Support Certification. To our knowledge there are no evidence-based strategies to guide family members toward referring their youth to SU screening and other treatment services. People with alcohol use disorder (AUD) cannot control how much they need and desire alcohol and, as a result, consume it in amounts that can lead to severe health issues.

The first step toward a person’s recovery is to acknowledge they have an alcohol dependency problem. Over the long or medium term, excessive drinking can significantly alter the levels of these brain chemicals. The problems relating to alcohol dependence are extensive, and its effects can be physical, psychological, and social. 6) Setting Boundaries – Establishing boundaries to protect the safety of everyone in the family and help create a healthier environment for recovery.

Prevent SUDs across generations—Help families recognize the intergenerational transmission of family patterns that promote substance misuse. Your goal is to help families prevent SUDs in current and future generations by encouraging parenting practices that help prevent SUDs in children, improve SUD treatment outcomes in adolescents, and enhance the family recovery process. It provides information about marriages, divorces, births, geographical locations, deaths, and illness over the generations.

Sometimes called the “opioid epidemic,” addiction to opioid prescription pain medicines has reached an alarming rate across the United States. Some people who’ve been using opioids over a long period of time may need physician-prescribed temporary or long-term drug substitution during treatment. Examples include methylenedioxymethamphetamine, also called MDMA, ecstasy or molly, and gamma-hydroxybutyric acid, known as GHB. Other examples include ketamine and flunitrazepam or Rohypnol — a brand used outside the U.S. — also called roofie. These drugs are not all in the same category, but they share some similar effects and dangers, including long-term harmful effects.

Reframe continuing challenges as normal, not as failures of the family or the counseling process. Teach families how to generalize the skills they developed in Phase 2 to new situations and contexts other than the initial target behavior. Frame the counselor-family therapeutic relationship as a cooperative effort between experts. Suggesting reading, audio, or video material the client and family members can review at home.

For instance, members of a couple in recovery may have different expectations for emotional and sexual intimacy; one partner may want more intimacy, whereas the other may find intimacy uncomfortable without using substances. SUD treatment services, which at first were mainly residential, began to incorporate family activities into their programs. The goal was to rally individual clients’ family members in supporting their recovery and to address the ways in which family members, particularly spouses, contributed to clients’ substance misuse. It is no accident that the terms “co-alcoholic” and “codependent” were applied to spouses. Early SUD treatment programs began incorporating family psychoeducation, but there was an inherent attitude of “them” (family) versus “us” (those in recovery or treatment). Family counseling is a collection of family-based interventions that reflect family-level assessment, involvement, and approaches.

Clients with partners in the BMT group were also more likelythan those with “Minimal Spouse Involvement” to complete treatment (McCrady et al., 1986). Eighteen monthsafter treatment, couples who had received BMT reported enjoying greaterrelationship satisfaction with fewer marital treatment and recovery national institute on drug abuse nida separations. In addition, the rateof abstinence among the BMT couples had gradually continued to improve aftertreatment ended rather than dropping off, as occurred with the other two groupsin this study and most other substance abuse treatment programs (McCrady et al., 1991).

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